Medicines for Heart Failure - Topic Overview
Because there is very good evidence that ACE inhibitors,
ARBs, beta-blockers, and spironolactone can prolong survival in people with
heart failure, your doctor will aim to have you take these medicines, if
Also, several other classes of medicines can be
helpful in relieving symptoms of people with heart failure. There is less clear
evidence that these medicines prolong survival, so your doctor will usually use
these second-line medicines only if you are already taking each of the main
classes of medicines or if you cannot tolerate one or more of the main
Second-line medicines for heart failure
How it works
|Vasodilators||These drugs relax the smooth muscle in your arteries
and therefore lower the amount of blood pressure the heart has to beat against.
Nitrates also dilate the veins, alleviating some of the congestion from blood
backed up behind the heart.|
|Calcium channel blockers|| These drugs are vasodilators. They may be
particularly useful in diastolic heart failure. But they may make systolic
heart failure worse. They slow the heart rate and decrease the force of the
contraction of the heart, which may prevent further damage to the heart. |
|Digoxin||Digoxin increases the force of contraction of the
|Warfarin (Coumadin)||Warfarin thins blood and prevents blood clots.|
What types of medicines are used in the hospital?
If you go to the hospital because of sudden heart failure, also called a flare-up, your doctor will first try to stabilize
your condition. The doctor will immediately prescribe drugs such as diuretics,
nitrates, and/or morphine to help you breathe more easily and
to control your pain or anxiety. These drugs should quickly relieve your
Your doctor may also order an oxygen mask that fits
over your nose and mouth. The oxygen helps make sure that your heart and the
rest of your body are receiving plenty of oxygen. After your condition is
stabilized, your doctor will try to find out what caused your flare-up and
whether your heart has been damaged.
First treatments of a sudden heart failure flare-up
What does it do?
|Diuretic ||Removes extra salts and fluid from your body|
|Nitrate||Dilates blood vessels and decreases fluid buildup in
|Morphine||Reduces pain and anxiety|
|Oxygen||Increases oxygen levels in your blood|
If these medicines do not help you enough, your doctor might try more aggressive medicines such as nesiritide (Natrecor) which helps relax certain blood vessels and gets rid of extra sodium and water from
the body. Nesiritide is only used after trying other
treatments. Your doctor will watch you closely for problems, because nesiritide can cause serious kidney problems, irregular heartbeats, and low blood pressure.